scholarly journals The London Initiative for Glandular Fever HIV Testing (LIGHT) initiative: integration of opt‐out HIV tests in primary care glandular fever serology order‐sets – simple, effective and sustainable increase in HIV testing in line with UK and European guidelines

HIV Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
Author(s):  
DTS Hsu ◽  
M Ruf ◽  
G Leong ◽  
S Douthwaite
2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S512-S512
Author(s):  
Jodian Pinkney ◽  
Divya Ahuja ◽  
Caroline Derrick ◽  
Martin Durkin

Abstract Background South Carolina (SC) remains one of the most heavily affected states for both HIV and HCV infections. Males account for the majority of cases. Implementation of universal opt-out testing has improved screening rates but not much has been published describing the characteristics of those who opt out of testing. This becomes important as 10-50% of patients have opted out in previous studies. Methods Between February and August 2019, we conducted a quality improvement (QI) project which implemented opt- out HIV-HCV testing at a single primary care resident clinic in SC with the primary aim of increasing screening rates for HIV-HCV by 50%. Secondary aims included describing the demographic characteristics of the opt-out population. Persons were considered eligible for testing if they were between the ages of 18-65 years for HIV and 18-74 years for HCV. This was prior to the USPSTF 2020 guidelines which recommend HCV screening for adults aged 18-79 years. A retrospective chart review was used to obtain screening rates, opt status and demographic data. Logistic regression and the firth model were used to determine linkages between categorical variables. We present 3-month data. Results 1253 patients were seen between May 1, 2019- July 31, 2019 (See Table 1). 985 (78%) were eligible for HIV testing. 482 (49%) were tested for HIV as a result of our QI project and all tests were negative. 212 (22%) of eligible patients opted out of HIV testing. Males were 1.59 times more likely to opt out (p=0.008). (see Table 2,3) Regarding HCV, 1136 (90.7%) were deemed eligible for testing. 503 (44%) were tested for HCV as a result of our QI project. 12 (2.4%) were HCV antibody positive with viremia. 11 (90%) of antibody positive with viremia cases were in the 1945-1965 birth cohort (see Table 4). 244 (21%) opted out of HCV testing. Males and persons without a genitourinary chief complaint were more likely to opt out (p=0.02). Table 1: Demographic characteristics of the population seen at the internal medicine resident clinic between May- July 2019 Table 2: Relationship between demographic variables and the odds of being tested for HIV or HCV within the last 12 months. Logistic Model. Table 3: Relationship between demographic variables and the odds of opting out of testing for HIV or HCV. Firth Model. Conclusion Although implementation of routine HIV-HCV opt-out testing led to increased screening rates for both HIV and HCV, roughly 1 in 5 eligible patients chose to opt out of testing. Males were more likely to opt out despite accounting for the majority of newly diagnosed HCV cases. Future studies investigating drivers for opting-out in the male population could improve testing and assist with early diagnosis. Table 4: Characteristics of patients newly diagnosed with HCV positive with viremia. Disclosures All Authors: No reported disclosures


AIDS Care ◽  
2019 ◽  
Vol 31 (12) ◽  
pp. 1565-1573 ◽  
Author(s):  
Lu Niu ◽  
Zixin Wang ◽  
Yuan Fang ◽  
Mary Ip ◽  
Joseph T.F. Lau

2021 ◽  
Vol 9 ◽  
Author(s):  
Greta Tam ◽  
Samuel Yeung Shan Wong

Background: HIV infections are generally asymptomatic, leading to undetected infections and late-stage diagnoses. There are a lack of acceptable testing strategies for routine opt-out HIV screening. Our aim was to evaluate and compare the diagnostic yield of routine opt-out HIV testing strategies in two out-patient settings in a low HIV prevalence country: The public primary care and specialist out-patient care settingMethods: A cross-sectional study was conducted in a primary care clinic over a four-week period in 2016 to 2017 and in a specialist out-patient clinic over a concurrent 11-month period. Patients were invited to complete a questionnaire assessing demographic characteristics, acceptance of opt-out HIV testing as a policy in all out-patient clinics in Hong Kong and reasons if refusing the HIV test. All respondents were offered an HIV test.Results: This study included 648 and 1,603 patients in the primary care and specialist out-patient clinic, respectively. Test acceptability was 86 and 87% in the primary care and specialist out-patient setting, respectively. Test uptake was 35 and 68% in the primary care and specialist out-patient setting, respectively. No HIV infections were detected.Conclusion: Opt-out HIV testing during routine blood taking in the specialist out-patient setting achieved a high test uptake and acceptability. In contrast, opt-out HIV testing using rapid finger-prick tests in the primary care setting was not effective.


2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Noemi Spinazzi ◽  
Ann Petru ◽  
Teresa Courville ◽  
Tricia Smallwood

2011 ◽  
Vol 89 (5) ◽  
pp. 328-335A ◽  
Author(s):  
Stephanie M Topp ◽  
Julien M Chipukuma ◽  
Matimba M Chiko ◽  
Chibesa S Wamulume ◽  
Carolyn Bolton-Moore ◽  
...  

2018 ◽  
Author(s):  
Tonderai Mabuto ◽  
Bhakti Hansoti ◽  
Salome Charalambous ◽  
Christopher Hoffman

2018 ◽  
Vol 20 (6) ◽  
pp. 922-931 ◽  
Author(s):  
Monisha Arya ◽  
Haley G. Marek ◽  
Rachel E. Marren ◽  
Vagish Hemmige ◽  
Richard L. Street ◽  
...  

Introduction. Despite national recommendations, routine opt-out HIV testing has not been widely adopted by physicians. Guided by previous research on physician barriers to HIV testing, we developed a physician-targeted video to promote routine opt-out HIV screening. The objective of this study was to evaluate this video intervention. Methods. From June to July 2016, physicians in two primary care clinics completed an online survey prior to and after watching the video. Survey items assessed acceptability of the video and HIV testing knowledge, attitudes, and intention to screen. Descriptive statistics were generated to analyze data. Results. Of the 53 participants, 90% liked or strongly liked the video. Pre- to postvideo, significant improvements were seen in the knowledge of national HIV screening recommendations (45.3% to 67.9%; p = .010) and of the proportion of unaware Houstonians living with HIV (22.6% to 75.5%; p < .001). Participant beliefs about the likelihood of patients accepting HIV testing increased from 47.2% to 84.9% pre- to postvideo ( p < .001). Intention to screen did not change; participants had high intentions pre- and postvideo. Conclusions. Our study found that a video is an acceptable HIV testing promotion medium for physicians. Our video improved physician HIV testing knowledge and attitudes, overcoming key barriers to HIV testing.


2015 ◽  
Vol 2 (6) ◽  
pp. e217-e218 ◽  
Author(s):  
Amanda D Castel ◽  
Irene Kuo
Keyword(s):  

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